FACTORS AFFECTING SUICIDAL IDEATION IN COMMUNITY-DWELLING OLDER ADULTS WITH DEPRESSION

Abstract Suicidal ideation (SI) within the older adult population represents a continuing public health crisis. The previously published 5D Framework utilizes a set of five domains (depression, disability, disconnectedness, disease, and deadly means) to explain multifaceted influences on late-life suicide. This study explored factors associated with SI among community-dwelling older adults with depression by including measures of selected 5D Framework domains and additional factors potentially associated with SI in an explanatory analytic model. We utilized baseline data from an ongoing clinical trial to assemble a cohort of older adults (age 65+) who screened positive for depression via provider diagnosis or scoring ≥16 on the Center for Epidemiologic Studies Depression scale (CES-D). Individuals joining the clinical trial between May 2017-March 2020 completed baseline assessments evaluating levels of depression, cognitive impairment, psychological resilience, dispositional optimism, social engagement, level of financial strain, and educational attainment. Sl was defined as endorsement of Question 9 of the PHQ-9. In the study cohort (N=171), mean age was 73.5 [SD: 5.76], 67.3% female, 92.4% non-Hispanic White, and 18.1% endorsed SI. In a multivariate logistic regression analysis, increased severity of depression was positively associated with SI (AOR 1.18 [95% CI:1.06-1.31]) while higher level of optimism was inversely related with SI (AOR 0.913 [95% CI:0.84-0.96]). No statistical significance was noted for age, gender, education, financial strain, resilience, cognitive impairment, or social engagement. We conclude that optimism is a protective factor against SI, and reporting more severe depressive symptoms represent an important risk factor for SI, among older adults with depression.

square and CFI<.01, was supported in the multigroup analyses across all levels testing equality in measurement and regression weights and residual variances.This lack of change in the model across 6 different grandmother scenarios provides further evidence supporting the need for interventions to address diagnosed depression and depressive cognitions for reducing depressive symptoms in grandmother caregivers.
Abstract citation ID: igad104.2147EVALUATING THE ACCEPTABILITY AND PRELIMINARY EFFECTS OF EMPOWER@HOME FOR GERIATRIC DEPRESSION Jay Kayser, Skyla Turner, Chuxuan Zheng, Samson Ash, and Xiaoling Xiang, University of Michigan, Ann Arbor, Michigan, United States Internet-based cognitive behavioral therapy is a cost-effective strategy for meeting older adults' increased mental health needs, but few existing programs are designed for older adults.Our team developed Empower@Home using user-centered design and community-engaged approaches.This poster presents results from year 1 of our ongoing uncontrolled trial (NCT05384704).Participants were recruited from a research volunteer registry, and community agency referrals.104 adults 50+ (M=63) consented and started the intervention in 2022, of which 96 completed the post-test and a 10-week follow-up (93% retention rate).Items from the Modified Treatment Evaluation Inventory showed high satisfaction and acceptability.For example, 95.5% agreed that the program was "an acceptable way of dealing with depressed moods," and 96.8% agreed that they "would recommend this program to others who experience depressed moods."Adherence was high, with an average of 8.5 sessions (out of 9 total) completed (n=103).Among those who completed the post-test (n=96), all but one finished the entire program.Intention to treat analysis showed a significant within-group moderate reduction in depressive symptoms as measured by the PHQ-9 from pre to post-test (cohen's d=.75).This effect size was large among those with a pre-test PHQ-9 score of ≥10 (cohen's d=1.31).The treatment effect was largely maintained at the 10-week follow-up.Significant improvements in post-test were also observed for secondary clinical outcomes, including anxiety (GAD-7), social isolation (DSSI), loneliness (PROMIS), Anger (PROMIS), and sleep quality.Empower@ Home is an acceptable and potentially effective program for treating depression in older adults.

University of Connecticut School of Medicine, Farmington, Connecticut, United States
Suicidal ideation (SI) within the older adult population represents a continuing public health crisis.The previously published 5D Framework utilizes a set of five domains (depression, disability, disconnectedness, disease, and deadly means) to explain multifaceted influences on late-life suicide.This study explored factors associated with SI among community-dwelling older adults with depression by including measures of selected 5D Framework domains and additional factors potentially associated with SI in an explanatory analytic model.We utilized baseline data from an ongoing clinical trial to assemble a cohort of older adults (age 65+) who screened positive for depression via provider diagnosis or scoring ≥16 on the Center for Epidemiologic Studies Depression scale (CES-D).Individuals joining the clinical trial between May 2017-March 2020 completed baseline assessments evaluating levels of depression, cognitive impairment, psychological resilience, dispositional optimism, social engagement, level of financial strain, and educational attainment.Sl was defined as endorsement of Question 9 of the PHQ-9.In the study cohort (N=171), mean age was 73.5 [SD: 5.76], 67.3% female, 92.4% non-Hispanic White, and 18.1% endorsed SI.In a multivariate logistic regression analysis, increased severity of depression was positively associated with SI (AOR 1.18 [95% CI:1.06-1.31])while higher level of optimism was inversely related with SI (AOR 0.913 [95% CI:0.84-0.96]).No statistical significance was noted for age, gender, education, financial strain, resilience, cognitive impairment, or social engagement.We conclude that optimism is a protective factor against SI, and reporting more severe depressive symptoms represent an important risk factor for SI, among older adults with depression.The relationship and communication between doctor and patient have important implications for the quality of health care received in old age.However, their role in healthrelated anxiety among older patients has received limited attention.In this paper, we explored the association between doctor-patient communication and doctor-patient relationship with health-related anxiety among 661 independent, retirement community-dwelling older adults.The mean age of the respondents was 77.81 years, and the majority (60.54 percent) were women.Our findings show a negative association between health-related anxiety and the doctor-patient relationship (b=-11, p<.05).We also found a negative association between satisfaction with communication and healthrelated anxiety (b=-.09,p<.05).The relationship between health-related anxiety and doctor-patient relationship and doctor-patient communication remains even after controlling for covariates.Older adults who reported better communication and relationship with their physician had lower health-related anxiety.Compared to Blacks, Whites had significantly lower health-related anxiety (b=-.80,p<.05).For every additional chronic condition, health-related anxiety increased by 0.22 (p< 05).Gender, education, and age, however, were not associated with health anxiety.Overall, our findings support the hypothesis that better doctor-patient relationships and communication are associated with lower health-related anxiety among community-dwelling older adults.

IT BOTHERS ME TO ASK FOR HELP: MODERATION OF SELF RELIANCE ON MASCULINE DEPRESSION AND SUICIDAL IDEATION IN OLDER MALES
Sabine Lohmar, Jeongwi An, Montgomery Owsiany, Erika Fenstermacher, and Amy Fiske, West Virginia University, Morgantown, West Virginia, United States Compared to females, males are less likely to seek help and less likely to be diagnosed with depression despite having depressive symptoms.Masculine depression, a 'masked' depression is associated with greater endorsement of masculine norms such as self-reliance.Self-reliance, or a preference to not seek help from others, is related to suicidal ideation in males.Although death by suicide remains the highest among adult males over the age of 75, research has yet to examine the role that self-reliance has on suicidal ideation in older males with masculine depression.This study examined the moderating effect of the self-reliance subscale of the Conformity to Masculine Norms Inventory (CMNI-30) on the relation between the Male Depression Risk Scale-22 (MDRS-22) and the Suicide Behaviors Questionnaires-Revised (SBQR).This study included 214 males aged 65 and older surveyed on Mechanical Turk.A multiple regression analysis indicated that self-reliance moderated the relation between the MDRS-22 and the SBQR (β =.220, t = 2.174, p=.031).Graphical representations of these data indicated that the relation between the MDRS-22 and SBQR was stronger in those with higher self-reliance.Thus, older males with masculine depression may be more likely to endorse suicidal ideation if they endorse self-reliance norms, or are less likely to seek help from others.This study illustrates the importance of self-reliance when understanding older males with elevated suicide risk.Future research should address how other masculine norms influence or explain the relation between masculine depression and suicidal ideation.

MIGRATION OVER THE LIFE COURSE AND LATER-LIFE DEPRESSION IN CONTEMPORARY CHINA
Nan Zhang, University of Manchester, Manchester, England, United Kingdom Migrating between rural and urban areas over the life course profoundly shapes the conditions of later life.In the Chinese context, living in urban areas with an urban Hukou is associated with socioeconomic advantage.This study is among the first attempt to investigate how migration into urban areas in China is related to these processes and the association with risk of depression in later life by focusing on the timing and the type of migration (rural-urban residential mobility and/or institutional transition of Hukou status) of migration.Using data from China Health and Retirement Longitudinal Study, we found strong associations between migration over the life course and risk of depression in later life in China.The timing and type of migration appears to play an important role.In-situ urbanisation is associated with lower depression scores in later life, and these effects are greater for in-situ urbanisation occurring in middle age compared with young adulthood.Forced urban-rural migration is associated with improved mental wellbeing.Formal social protection, particularly having a private pension, contributes substantially to the mental health advantage of social groups